| Address: Mumbai Suburban, Maharashtra |
Dear Sir/Ma'am,
this is a complaint letter against MediAssist India Pvt. Ltd, a TPA Insurance company located in Andheri East, Mumbai.
Myself, Kanhaiya Maheshwary, underwent a surgery for Pilonidal Sinus on 30th April, 2013 at CritiCare Mutli Speciality Hospital, Juhu, Andheri West, Mumbai. A few days before the surgery, I had intimated the above mentioned insurance company with which I hold a MediClaim policy.
The officials from the above mentioned insurance company even visited the hospital to confirm all the details.
After my surgery, I submitted all my original documents and claimed for reimbursement. However, a week after filing the insurance claim, I received an email stating that my claim has been rejected since there's a waiting period for the condition for which I've been operated.
So here's my first question - If I had intimated the insurance company prior to my operation, why didn't they inform me that I cannot file a claim for the above mentioned condition?
Secondly, I had submitted a withdrawal claim in order to get back all the original hospital bills and documents since I have another mediclaim policy under which I want to claim. I had filed the withdrawal on 20th June, 2013 and was informed that I will receive my file within 8 days. It has been 15 days since then, and there's no answer from their side.
1. I call daily, but am informed that the file hasn't come.
2. Whenever I call, the executives cut the call even without listening to me.
3. The executives informed me that the file has been dumped in the godown. If the file is supposed to be given back to me, why is it dumped in the godown!?
My time for filing the claim under the second insurance policy is running out, and If I'm not able to submit my original papers in time, I will incur a loss of almost Rs. 50,000. All this will be due to the negligence by MediAssist India Pvt. Ltd.
And here are my details:
1. Claim Number: 2794442
2. Policy No. 131300/48/2013/19731
Also. Attaching herewith a screenshot copy of the email I had sent to MediAssist India for withdrawing my original documents.
- Kanhaiya Maheshwary
Rejection of claim
I am an employee of Canara Bank my ID is [protected]@ibacanMy many claims for domiciliary treatment are pending for the reason not informed to me and for some claims now status shows cancelled
I wish to know the details /reason of the claim which are either pending or cancelled
Prakash holay